by Nicole Cutler, L.Ac.

As one of the many amazing functions we are capable of, the human body can produce Vitamin D simply from its exposure to the sun’s ultraviolet rays. Since researchers have recognized that most people with chronic liver disease have a Vitamin D deficiency, it seems logical that those with chronic Hepatitis C seek opportunities where they can enjoy the sunshine. However, those undergoing treatment for Hepatitis C are at an increased risk of burning from the sun’s rays. Known as photosensitivity, one of the medications used in Hepatitis C combination therapy has been identified as having the potential to heighten sunburn vulnerability.

The Need for Vitamin D
Presented in October 2008 at the 73rd Annual Scientific Meeting of the American College of Gastroenterology, researchers from the University of Tennessee in Memphis measured the vitamin D levels in people with chronic liver disease. Of those evaluated, 85 percent of the study participants had chronic Hepatitis C, and 92.4 percent of those with chronic liver disease had some degree of vitamin D deficiency.

Since Vitamin D can be made in the body from sunshine, this study provides plenty of incentive for those with Hepatitis C to seek sunny destinations. But just as with anything that is seemingly beneficial, there are limits and safety issues associated with upping Vitamin D via the sun or via supplementation. For more information about Vitamin D, consequences of its deficiency and safe amounts to supplement with, read Caution: Hepatitis C and Vitamin D Deficiency.

Photosensitivity
Dozens of medications, both prescription and over-the-counter, can increase a person’s sensitivity to sunlight. Photosensitivity is a well-known side effect that causes some people to:

· burn more easily
· burn more quickly
· get hives or rashes
· have other skin eruptions

While this list is not exhaustive, some commonly used medications listing photosensitivity as a side effect include:

· Antihistamines
· Non-steroidal anti-inflammatories (NSAIDS)
· Antibiotics including tetracylcines and sulfa drugs
· Antidepressants
· Anti-psychotics
· Cardiovascular drugs
· Cancer chemotherapy drugs
· Oral diabetes medications
· Diuretics
· St. John’s wort (herbal remedy for depression)

Ribavirin
Although it is not categorized as a common medication, the antiviral drug ribavirin may cause or enhance photosensitivity. As an integral part of the prescribed treatment for Hepatitis C, some individuals develop a rash from ribavirin – and this side effect can be exacerbated by exposure to intense sunlight or other UV light, such as tanning beds. In addition, consumers are urged to be aware of the greater potential for a photosensitive reaction when combining ribavirin with one of the above listed drugs known for increasing sensitivity to the sun. For those especially sensitive, a photosensitive reaction may also be triggered by indirect sun exposure, such as light reflected off pavement.

Protect Yourself
Although the skin burns or rashes characteristic of photosensitivity can cause pain, itching and misery, combination therapy for Hepatitis C needn’t keep you confined indoors (unless advised by a physician or pharmacist). For the majority of individuals on photosensitive medications, several extra precautions can help prepare for sun exposure.

The following five tips will help you reap Vitamin D from the sun, even if you are on Hepatitis C medications:

1. Avoid prolonged exposure to sunlight during the high intensity hours between 10 a.m. and 4 p.m.

2. Use a broad-spectrum sunscreen with an SPF of at least 15, preferably 30 – which protects against both UVA and UVB rays. Although most sunburns are caused by UVB rays, some photosensitivity reactions are triggered by UVA rays.

3. Use at least one full ounce of sunscreen 30 minutes prior to sun exposure and reapply after swimming or excessive sweating.

4. Wear protective clothing such as wide-brimmed hats, sunglasses and sun-protective clothing such as tightly-woven, long-sleeved shirts and pants or clothes with a high SPF rating.

5. Women who wear makeup should use makeup containing a sunscreen of SPF 15 or higher.

Since those with chronic Hepatitis C are likely low on Vitamin D and sunshine helps produce it, the arrival of warm, sunny weather is especially embraced. However, those being treated with ribavirin must understand the additional photosensitivity risk of sun worshiping. By being reasonable with your sun exposure levels and properly protecting your skin from radiation, Hepatitis C treatment need not stop you from frolicking in the light.

References:

http://drugs.about.com/b/2008/07/18/sunlight-and-your-medications-may-not
-mix-staying-healthy-at-the-beach.htm, Sunlight and Your Medications May Not Mix: Staying Healthy at the Beach, Michael Bihari, MD, Retrieved April 2, 2009, About.com, July 2008.

http://www.eurekalert.org/pub_releases/2008-10/acog-vdd100308.php, Vitamin D deficiency common in patients with IBD, chronic liver disease, Retrieved April 4, 2009, American College of Gastroenterology, October 6, 2008.

http://www.hivandhepatitis.com/doctor/topics/hcv1.html, Questions from Readers and Answers by Medical Experts on Treatment and Care for Chronic Hepatitis C Virus (HCV) Infection, Mack Mitchell, MD, Retrieved April 2, 2009, hivandhepatitis.com, 2009.

http://www.sciencedaily.com/releases/2000/08/000807070850.htm, Medications May Increase Sensitivity To Sunlight, Retrieved April 2, 2009, ScienceDaily LLC, August 2000.

Palmer, Melissa, MD, Dr. Melissa Palmer’s Guide to Hepatitis and Liver Disease, Avery Publications, Revised Edition 2004; 194-195.

http://www.hepatitis-central.com